Abnormal Discussion Week 2: If People are not Labels, then People are not People

The theme of my night: People are not people. People = a label. Gotta love it. So people ARE labels, then?

I love this course material. PSY 424. I'm actually enjoying the material. Almost as much as I enjoy ethnic and feminist literature (I said ALMOST, don't get carried away...). The discussion posts made by most students in this on line course are, as you might imagine, much shorter and less...well, less...


Anyhow, I plan to post my discussion posts on my blog when I think they are worthy of being read by someone other than me.

QUESTION 1

Question Posed: Many people argue for a “people first” approach to clinical labeling, recommending, for example, the phrase “ a person with schizophrenia” rather than “a schizophrenic.” Why might this approach to labeling be preferable?

Simply put, it would be inaccurate, unnecessary and insensitive to use a label that describes one aspect of an entire person in order to characterize the entire person. While most of us know that a person is not her or his disorder, a person is not her or his sexual orientation, a person is not her or his physical condition; it is difficult for the majority of us to define what makes a person a person. We spend a great deal of time, as humans, trying to understand and develop our individual personalities. We are constantly bombarded with messages in the media that encourage us to define ourselves in terms of one of our preferences: what music we like, what coffee we drink, what kind of e-reader we use. The media banks (CHA-CHING!) on our desire to Be Somebody - to identify with something, to associate ourselves with something larger than ourselves. If we feel a sense of belonging and community in something (in a group, for instance), then we are likely to feel a certain degree of pride in the label attached to that community. If we feel isolated and alone in something (in a long-time struggle with a family member, for instance), the we are likely to feel a certain degree of shame in the labels and meanings attached to that struggle. In that regard, the degree of isolation and sense of belonging largely determine our perceptions and feelings about any given label. But, whether we shun or embrace a label, people are still not labels.

Even the term "people" is just a linguistic device created to for the purposes of communication and identification. Though it's hard to definitively say why or how, there does seem to be some human drive that propels us to create language in order to interact and communicate with others in the world. Speaking of language and labels, I was captivated and intrigued by Halgin and Whitbourne's description of the Diagnostic and Statistical Manual of Mental Disorders as a "common language."  Though I doubt the authors considered the linguistic connotations and connections and interpretations that can be made in connection to the organization and delineation of disorders, their reference to a common language is a perfectly fitting and far-reaching descriptor. I appreciate the way in which the authors frame the language of disorder as a "common language" because it evokes the simplistic yet profound idea that we all espouse in some form or another: to engage in a common language. We seek, in our work environments, in our romantic relationships, in our home life, to create and relate a common understanding. We seek, and it is very natural and beneficial to do so, community and communion and communality. A common language can free us to be ourselves, but it can also confine us. It benefits us to identify with and feel part of a community. However, if we become so identified with and infiltrated into one community, or into the foundational language that creates that community, we may lose sight of ourselves as individuals within that community. We may even become so accustomed to the body of language that we cannot see or think beyond it.

Language is both the creation of community and the creator of community. Before spoken and non-spoken language, there existed a non-verbal, non-human realm communication. The movement and interaction of the elements is a very synchronous and cyclical form of communication. Non-human elements in the world interact and come together in various ways. Water is absorbed into the air and comes back down to earth in order to water the land that harnesses the seed from which something, in direct sun or in partial shadow, grows to feed a hungry land creature that puts something back into the soil to replace what it has taken. We could look at human communication the same way, were it not for the great many languages that have allowed us to define and redefine and deconstruct our natural place in and relationship with the world as well as the language of living. I very much see the common language of the DSM as having dual-roles as both explicator and creationist. I think the authors of "Abnormal Psychology: Clinical Perspectives on Psychological Disorders" provide an excellent framework in Chapter 2 for understanding the purposeful yet limited and limiting nature of the DSM. It, like any language guide, provides its disciples and speakers (from varying backgrounds and at varying levels of fluency) with a evolving framework and instructive guide. It, like language, is a way of looking at something - it's a world view in and of itself because it creates a world view. As with any world view, there will always be limitations and contradictions with which its visionaries must contend.

In "The Dream of a Common Language," Adrienne Rich provides a poetic language for and about women by speaking in the language of women. Rich's collection of poems, separated into three sections, is, indeed, a "whole new poetry." The creation of a language arises when their is a need for such a language. The need exists because one of more members of a group, often a silenced and invisible majority or an oppressed minority group, desire to articulate their experiences in order to preserve their experiences and create a sense of community among themselves. More than anything, though, the language of the group is created in order to reach out to those outside the community in order to seek understanding and compassion from outsiders and oppressors in the hope that such an understanding will create change. The DSM was first developed in 1952 by the American Psychiatric Association. As in the case of Rich's poetic language, and the way it spoke to and about lesbians and marginalized/outsider women, the American Psychiatric Association sought to create a common language to speak to and about psychological disorders. It sought in its earliest form, on a very elemental level, to challenge misconceptions about mental health and unhealth as well as to create a communal resource and framework for, in which ratings and criteria and definitions could be used to connect insiders to one another and outsiders to insiders. It served and still serves as a tool to dispel stereotypes and stigmas that leave individuals with mental illness feeling isolated. It serves as a common language among mental health professionals as well as a way tool for those who have experienced mental illness to understand themselves and feel connected to the common language. And, for those outside of the mental health profession, it provides an informative framework into which the common language can be accessed, processed and comprehended. On the other side of that common language is the unfortunate fact that there will always be someone or something left out of that language. While language seeks to make outsiders insiders, it inevitably excludes and, therefore, creates outsidership. If there is a community to be in, there is also a community to be marginalized from.

Besides the limiting and dualistic nature of language itself, a common language always is vulnerable to misinterpretation and misuse. That is to say, sometimes we let the power of language go to our heads. Sometimes we forget that language is just language, becoming so caught up in the story of one common language that we lose our ability to interpret and experience the world in new ways, with new languages and new stories. That is my fear for the DMS and for the field of Clinical Psychology itself. The authors, however, do a wonderful job of calming my fears in their very comprehensive and sensitive presentation of the language. Halgin and Whitbourne offer us a very human-oriented and human-based approach to the subject of Abnormal Psychology, by providing us with the essentials of the common language while at the same time staying case (or individual) focused. They don't force us into a common language of dualistic labels; they, rather, apply the common language unobtrusively and without pretense into real life situations. I certainly have my own concerns about the ability of the powers that be in the mental health industry to influence and dictate our perception of mental health through their construction of a common language (with financial pressures from insurance companies to over-diagnose and overuse the label of disorder in order to suit the medical-model that allows the field of mental health to be a financial industry).

Anything that becomes part of what Minnie-Bruce Pratt calls "The Money Machine" is susceptible to becoming so caught up in the financial side of things that it loses its authenticity and effectiveness. Still, if the DSM is handled with care and thoughtfulness, as it was by the authors, I feel it can be a helpful common language. It all depends on the context and the individual situation - which is what the "people first" (and relationship-oriented) approach to clinical labeling is all about. I am curious about the theoretical background of the authors, since their style and approach appeals so much to me. I very much appreciate how attuned they are to the dimensionality of the individual. It's hard to read this chapter, even in light of the differing views that are presented, and not feel at ease about any fears you have about the dehumanization of the mental health diagnostic approach.

QUESTION 2

Consider the reasons why treatment is not always successful. How do the client’s insight, judgement, motivation, and ability to change affect treatment success? How do the clinician’s education, modality, competence, and theoretical orientation affect treatment success?

There are many things that might affect the success or failure of a treatment. Modality certainly would affect the types of treatments, as well as the goals for (and criteria for the success or failure) treatment. In a group therapy setting, the goal might be more centered on improving the functioning of the family unit as a whole; whereas in individual psychotherapy the goal would likely be more centered on improving the functioning of the individual (however - an improvement in individual functioning always leads to an improvement in interpersonal or communal functioning). It's hard to say how, exactly, the personal and theoretical orientation of the client and clinician affect treatment success. That's like trying to pin down the cause or root of a phenomenon. We can say everything affects everything, so yes, of course, insight, judgement, motivation, education, competence and theory would all affect one another and engage in an interaction that would affect the overall clinical process. Defining treatment success is just as difficult. We would have to have a very strong theoretical background, as well as a deeper knowledge of each of these qualities of the clinician and client in order to really say how the set of circumstances and characteristics come together to form a working relationship that results in treatment success or failure. It's also very difficult to define success or failure. Even a small step in the direction of mental health (of functionality) or a step away from isolation might be considered a success.

As we discuss this topic, I think it will helpful for each of us to think about how we might define success in a psychotherapeutic setting. I can't say anything about how any other client or clinician might define success. It's even hard for me to say how I would define success because I don't have the first-hand experience and I have never though about this subject before. I'm glad to be considering it, though. I have never, formally, been a clinician; however I have been a client. When I came out of the closet as a teen, my parents arranged for me to see therapists (it was my mother's desire that I should guided, through therapy, out of my defiant state of lesbianism). I saw a few clinicians at that time. I only considered one of those clinicians successful. But I still have trouble defining what made his approach successful in my eyes. I believe it was mostly a manner of his gentle-nature and theoretical orientation. I cannot actually define or point to definitively his theoretical orientation, I can only say that I felt accepted. I did not feel any pressure to tell him the lies I was telling everyone else. When I told him that I believed the love between the person in my past and I was mutual, and filled him in on why I felt/thought that way, he did not react with hysteria. He did not diminish nor negate my feelings. He honored my autonomy and even validated my feelings and experiences (not just by listening but by showing empathy and, dare I say, compassionate love).

To this day, I think about this man (he is a pastor and is near retirement) and wish that I could have continued seeking out his acceptance and moral guidance throughout my life. That was the closest thing to acceptance, in a counseling situation, that I experienced during that emotionally profound time in my life. I actually think it was his motivation-less mindset that made our work together successful. He did not seem to go into it with an agenda. Perhaps after he evaluated me, he felt that the best treatment plan was to provide me with a safe place of listening and true acceptance. I was, at the time, experiencing a great deal of unacceptance in some of the major realms of my life. Given that, I think he thought what he could best provide was a place of acceptance. Listening and acceptance and story-sharing and validation WITHOUT an intention to change or alter anything may have been his treatment plan. Isn't it ironic. His lack of seeking, his lack of a plan to change me was actually the thing that most affected (and perhaps even changed) me. What I needed more than anything, at that time, was a person I could trust and confine in and feel safe with. I did not have to worry that he was going to report the teacher I loved or tell my mother what she wanted to hear or request that I not label myself as a lesbian "just yet." Just knowing he was in the world, with the impression he made on me, made me a stronger, healthier person who felt she wasn't completely alone (who felt a great deal of relief knowing that someone out there, even just one single person, could understand and honor my love and perhaps even believe me).

He did just what I needed: he made me feel sane and acceptable. I felt sane and acceptable on some level, but my mother was forcing another message down into my psyche - that I was crazy, deranged, sick, evil. I don't know whether or not he felt he was successful with me, especially given that we had to stop meeting fairly early on because my parents could no longer afford it. I only know that I perceive myself as having benefit from it. I would like nothing more than to someday be able to provide that acceptance and validation for someone like myself who is isolated by their own intelligence and open-mindedness. Sometimes people just need support when they are in a place of isolation (when they find that they cannot relate easily to the majority of other around them, for whatever reason). My personal account as a client of counseling raises an interesting set of questions about the mutuality and/or separateness of client/clinician perception: Can a clinician feel she has been successful if her client does not feel it has been successful (in other words, can the perception of success by anything other than mutual? Is it still success?).

The Lesbian Lawyer who wanted to be a Counselor who wanted to be a Performer who wanted to be Famous for Anything who wanted to be a Writer who wanted to be a Judge

This was my guide and partner's, response, after I read her aloud my first discussion entry on body piercings for my online Abnormal Psychology class: "That was a comprehensive and exhaustive response...Are you sure you don't want to be a lawyer?" Then she said, "I'll just call you Perry Mason." I said, "I wanted to be a judge when I was little, remember?" She said, "Yeah, well, I think you have to work your way up. You can't go to Judge School."

Maybe I'm a lawyer at heart? Or maybe at heart, I have the body and mind of a legal advocate. I have the spirit of a fierce advocating "tear you to shreds" kinda lawyer, but I also hate in-person confrontation and I smile and laugh out of anxiety too much.

Actually, I prefer to do all of my defending in writing. In person, I'm more docile and easy-going. So what am I? I was a lawyer in my English classes, and I'm sort of a kind of unorthodox lawyer in my poetry. And now, I'm a lawyer in my Psychology courses as I prepare to become some kinda Clinical Psychologist. Why can't I figure out what I wanna/gotta be when I grow up?


------------ See Below for My Discussion Response to Abnormal Psychology Class Topic --------------

 Many theorists worry about a growing trend toward “victimization” in our society, a tendency to portray undesirable behaviors as inevitable or uncontrollable consequences of early mistreatment or societal stress. What might be some of the dangers of over-applying the “victim” label?

When theorists equate the trend of "shirking responsibility" with "victimization," they are incorrectly confusing two distinct and asymmetrical issues. There is no over-use of "victimization" because "victimization" itself is not debatable. A person is either a victim or not a victim. If a person is pathological liar and claims to be a victim, then we might question whether or not he is a victim (based on our knowledge of him as a pathological liar). Regardless of what we believe and what he tells us, his actual LIVED PAST (which is not accessible to us in the present outside of his narrative, unless it was caught on video - in which case, other gray areas regarding victimization would arise) is the ONLY determiner of his victimization. If he suffered an abuse of some form or another, to any degree or in any context, then he is a victim of abuse. The issue that the theorists seem to be raising is NOT actually about victimization (the act of one victimizing another being), but about a mentality of irresponsibility that informs a growing trend of the misperception of victimization.

In order to begin to approach the questions that Dr. H-R has raised, we need to first consider definitions of victimization. So far, I am not finding a clear and clean and easy definition. I suppose that helps to explain why it is so difficult to answer questions definitively about victimization. Victimization can take on many forms and can occur in many contexts and can be perceived or misperceived on many levels. Victimization may involve a range of injustices: from some benign form of unfair treatment, such as is present in favoritism, to a great ethical breach to an extreme violation of a social rule in which a victimizer commits an injustice (or harm) against a victim. Is victimization determined by the consequence or upon the action/interaction itself? Again, this leads us into philosophical and legal terrains. Who holds the victimization card? Who gets to say what is and is not victimization? It just reemphasizes the issues that exist on a grander scale - issues of perception. Each of us perceives the world in a unique light, through our own experiences, the make-up of our brain and our individuality/personality. Each of us possesses our own, unique perceptive lens through which we define and judge the world that we see-and-perceive. We can never truly see the world outside of our own lens, and so we are cripplingly limited in our ability to define anything for anyone (even for ourselves). A written definition is created in order to create a standard, or shared idea, among a community of individuals. The limits of any definition for a word/concept, "victimization" included, will always arise out of one mutually agreed upon world view. Just because a consensus exists does not mean it holds rights over a concept or is not limited in its consideration or application of that concept. Each of us is going to write about this topic (which I, through my lens, see as being about the prevalence of irresponsibility in the Western World) in her own singular way.

From my perspective, victimization can be looked at from three (if not more) directions: from the perspective of the supposed victim, from the perspective of the supposed victimizer and from the perspective of those on the outside (direct or indirect witnesses). A person who does not see herself as a victim may still, indeed, have been victimized. A person who sees herself as a victim feels like a victim. She experiences herself as a victim, or as having been victimized. Whether or not we, as witnesses, believe that the situation in which she earned the label of victim warranted that label; she, herself, still feels suffering because of some injustice in the past or present that she perceives. Regardless of the situation itself, someone who believes she is a victim is a victim (yes, even if she is only a victim of herself, of the oppressive mentality of victimization that renders her the victim and contributes to some part of her suffering and perception as having been harmed). In this sense, we are all, by some cause or another, victims. We all experience suffering, sometimes because of harm that another intends to commit against us and sometimes because of random circumstance.

Since we can never truly know the root of our suffering (or of our consciousness or of anything, really), then we cannot really know the root or validity of victimization. We can, however, separate the common concept of victimization from the concept of unethical behavior. We can expand our view by considering that people who commit unethical actions or unjust abuses against others can ALSO be victims. There are victims who commit abusive offenses against others and there are perpetrators who have abusive offenses committed against them. For as many different kinds of people there are in the world, there are as many different kinds of victims - because people are victims and victims are people. As we know, it is very common for a perpetrator to have been a victim in childhood. There are people who intend to victimize others and there are others who victimize by default. We cannot pinpoint WHO victims are or WHAT victimization looks like.

There are no dangers in over-applying the victim label. There are dangers in excusing and dismissing behaviors that are harmful to a society in which the values of democracy and fairness are upheld. There are dangers in enabling DANGEROUS BEHAVIOR. There are no dangers in over-applying a label ("victimization"). The label exists because we, as humans, have no better way of understanding or articulating the dimensions of our existence that cause our suffering. There exists no trend in "victimization," although it is entirely possible to consider, separately from the topic of victimization, a trend in irresponsibility.

To make it short and simple, for those who like it that way: There is a danger in confusing victimization with irresponsibility. In a Clinical context, I content that over-applying the victim label is not harmful but that excusing unhealthy behaviors for any reason would be disconcerting.

------------ See Below for My Discussion Response to Abnormal Psychology Class Topic --------------

In the Western world, body piercing is a fad. In other countries it marks status and may be performed as a ritualistic ceremony. Some research suggests that numerous body piercings may be a form of self-mutilation. Is body piercing a form of self-expression? Can we use our bodies as a canvas to express ourselves or is it an indicator of mental illness?

I anticipate that many of us will continue coming back to the underlying difficult nature of determining or classifying abnormality. The process of defining something as abnormal, from a clinical perspective, is complex and can be explored through many perspectives. At each level of our understanding of normality, we are faced with having to break down that given dimension of "abnormality" in order to determine through which angle we are going to view it. It is so very complicated. I think a comprehensive approach is necessary in order to treat the labeling of an individual or a behavior as abnormal. Although a comprehensive approach is much more difficult and requires the ability to have a wide and versatile view of human behavior; it seems to be the most effective (although perhaps not the most efficient) and helpful way of dealing with the difficulties of addressing the concepts and realities of abnormality and mental illness. The way in which we view any behavior, including body piercing, will be informed by the way in which we view the many intricacies of abnormality. It is difficult to address "body piercing" as a whole (as one, singular category of behavior) because there are so many things to consider about the "behavior" itself. Dr. H-R's set of questions highlight the many forms that the behavior of body piercing might assume as well as the many contexts in which they may or may not exist.

Even when we have information about the cultural or social context, we still are left with other questions (other levels to explore) regarding the individual. Even when we have information about the individual, we still are left with various avenues (life experiences, possible trauma, details about the piercing history itself) to explore. Just like the patters of the returns to and exits from the institutionalization of (and to institutionalized practices in regard to) abnormal individuals, I see the academic (and/or clinical, and/or qualitative) study of abnormality as being in a transient and repetitive (if not cyclical) state. When I consider the way in which Halgin and Whitbourne introduce abnormality to us (linguistically, organizationally and conceptually), I imagine entering a large building (an asylum, if you will!) in which there, laid out before you, are a series of doors. When you enter one door, you end up in a room with one door behind you and several doors ahead of you - you can exit and return to the original entrance of doors to choose another door or you can move forward into one of the next doors. Through every door there awaits another group of doors. After you've entered so many doors, you might wish you could turn around and start all over again but it's hard to imagine going back through all the doors you entered. You may wish, at some point, that you had never entered the building (of knowledge/of theory/ of psychology/ of brain and behavior studies).

It seems there is a whole range of acceptable behavior and a much more narrow range of unacceptable behavior. And even when a majority renounces one behavior (or even one particular instance or form of that behavior), there may be credence to a minority voice that goes against the grain to defend that instance or form of behavior. In other words: it's hard to judge even when we have the most details we could hope for. All we CAN do, given that inescapable quandary, is try to have as comprehensive of an approach to abnormality as possible. Body piercing, like abnormality, can be many things. I don't feel comfortable making generalizations about what body piercing is or is not, given that it is so many things to so many different people. I do -believe- that we can use our bodies in order to express art, but I also -believe- that art is an outlet for creative thought and emotional expression. Think about it - creative thought and emotional expression are associated with the brain. So some might say that some art, as an extension of what is going on internally in our brain and body, expresses mental illness (or mental health!). I think the best we can do is pay attention to the case of the individual - to find out, as much as possible, how the behavior is affecting her life (and that is even more important, I think, than finding out or classifying what purpose she might say it serves). As stated in Chapter One of the text, there are four criteria used by Clinical Psychologists to determine whether or not a behavior should be considered "abnormal:" Distress, impairment, risk, and social or cultural standards for acceptable behavior. If I were to look at an individual and her relationship with body piercing, I would try to consider the role of distress (whether or not the behavior/relationship is causing distress, if it came about because of a distressing situation or if the act is sought out in moments of distress). If distress was a factor, my next step would be to determine whether or not the distress is intense enough to lead to an impairment in her ability to function (and at what level the functioning is at - which might be hard to determine in and of itself). If a degree of impairment is occurring, the next step would be to determine what, if any, risk the behavior might be causing her or others (and this, to me, seems like the paramount criterion...but I can imagine it would be difficult to determine the level of a given risk). And, of course, it is important to consider and evaluate the social and cultural context in which the behavior (body piercing) is occurring.

Ultimately, for me, I would be most concerned with the behavior if it was causing pain or risk or consternation to the individual receiving the piercings. Even if a person is piercing as an act of self-mutilation, the behavior might be more desirable than other self-mutilating acts the person might commit had they not had the piercing option. If the self-mutilating person were interested in exploring other options for dealing with the internal factor that might be contributing to the behavior, then it would make sense to offer alternative solutions. If a person feels good mutilating herself, then why stop her? Who is to say what is good or bad for her? If it IS impairing her ability to function, then that is a sign that something unhealthy is going on. However, if she enjoys the act and sees it as the healthiest possible way of "being herself" or "dealing with emotions," then who am I to do anything but offer her some alternatives and support her in a behavior that doesn't directly harm OTHERS (outside of the pierced individual). Who am I to say what is an unhealthy or healthy way of coping and surviving? If someone is suffering and wants to change, then there is an opportunity to work with her. If someone is causing others to suffer and doesn't want to change, then that brings up a whole other issue. If a girl's father says he is suffering because of her piercings, I would encourage the father to seek help rather than the daughter (or for both of them to seek help together). If the girl were trying to pierce her father in his sleep, then I would consider her an actual harm to his safety and to his right to privacy and to be safe from external harm - and so I would say that is where the law and legal boundaries should come in. It's so complicated and tiring to consider, but I have done my best with having read the first chapter.

A Mother Who Tries.

Today is a very special day. When my mom called this morning, she asked if we got Pookie a present for her birthday. I suddenly felt anxious, self-proving and self-doubting. No we hadn’t. I started blabbing on about how Bouka had just had the onslaught of birthday and Christmas gifts in Buffalo, that we had a tea party with Adam and Elisa yesterday during which Pookie opened two gifts, that I made chocolate chip cookies with the girls yesterday, that I bought stuff for Pookie and Bouka to make their own pizzas. Yada, yada, yada. Then I stopped myself. I should have stopped myself before I started. All I needed to say was, “No we haven’t.” I could have left it to her to respond in her own way, instead of trying to anticipate what she was thinking and how she would feel about it. Am I such a weak and wavering person that I cannot decide for myself how I feel about my daughter's birthday? Are my decisions always made out of anxiety about how someone else, Sandy or my mother or someone in the sky, will interpret and feel about it? I guess so. Bummer! I would tell to myself, “I gotta be stronger than this,” but that would just be more down-talk. It’s better than the onslaught of escapist and avoidant excuses. It’s better than the manipulation that I am so tempted to perform.

So what do I want to do for Pookie’s birthday? Here’s how I REALLY see it (I think. I hope. Hell, who knows if it really is – what a joke, to suggest that I know something). Here are the facts, the details about Pookie’s birthday thus far. Pookie’s Aunt Missy (Moogoo, as Bouka recently called her) had an amazing two-part celebration for her in The Buff in December. She (Moogoo) paid and made arrangements for the extravaganza at Chuck E. Cheese. It included all of the cheesy trimmings (literally, the salty cheese on the pizza was included) and loud noises that a kid could ask for. As if that wasn’t more than enough already, Melissa and Brian had us over their house for a birthday sleepover (a big slumber party with siblings and parents and even one grandmother scattered around the Osterhaut). Missy spent all day cleaning her house to make it nice and special for Pookie. My mother had a specially ordered strawberry Coldstone cake decorated just as Pookie ordered. I mean, requested! To top it off, Melissa decorated the upstairs bedroom with streamers, balloons, colored lights, books, and toys (yes, even beanbags from her sixth grade classroom). Pookie got to have a sleepover with her fun and festive Aunt Missy and her older cousin, Rachel. Her fourth birthday was a dream come true, thanks to Aunt Missy who loves her nieces to pieces and did her sister a huge favor. Am I taking the lazy way out by not decorating and doing the party (part II) thing? I don’t think so. Pookie has already had the extended family bash and the extravagant fun. Pookie has already opened loads of material gifts.

What can I do for Pookie that she hasn’t already had on her fourth birthday? I can spend time with her, which is what she loves best. When I agree to play with Pookie, she rejoices and runs to kiss and thank me. I can tell her stories (what she calls “Stories from Mouth”) about when she was little, and about all of her past birthdays. I can make her pizza stations when she makes herself a pizza. I can close my laptop and pile up on the couch with Pookie and Bouka to watch a movie and snack on popcorn. Whether or not those things are costly, those are the things that bring Pookie the most lasting and meaningful joy. If Pookie had her heart set on a material gift then my focus would be on that, too. If I saw something that Pookie would really enjoy (like “Matilda” or a box of Skittles), I would wrap it up for her. If she hadn’t already had balloons and if Gramma Sue weren’t sending more, I would put up balloons. But given the circumstances, this part of her birthday doesn’t need to involve another material gift. I like the idea of action-oriented gifts. I also like recipient-centered gifts. These are my gift-giving aspirations. Pookie’s heart is not set on material gifts, her heart is set on family.

Last night before bed, she said to us, “Yay. Tomorrow is my birthday! That means I get whatever I want. Momma Si, you told Mommy on her birthday that she could do whatever she wants. I get to do whatever I want, too.” “Oh yeah? What do you want to do?” Pookie wiggled excitedly and said, “I want to watch a movie with my family. And I want to play a board game. With my whole family!” She told us what mattered to her. When she tells me something, I want to listen. I try to listen and I will continue to try to listen to her, despite all the other voices in my head that tell me what I should or should not be doing. I want to give Pookie the best gift I can give her: a mother who tries to listen to her. She isn’t the same person as me. If I like lots of material gifts and traditional festivities (I won’t say whether or not I do because it varies...but mostly I do like some of the extravagance), it’s about me (not her). I want to try to let Pookie tell us who she is. I want her to figure out for herself who she is and what she likes on her birthday instead of dictating it for her so that she doesn’t know who she is or what she likes. That’s not easy. If you think I’m ambivalent about all of it, it’s because I am (a highly ambivalent, indecisive, conflicted person). Writing helps me to sort my thoughts in times like these so I can start, or at least start to attempt, to filter out some of the crap I'm telling myself from my true values and beliefs. But, without all the crap what's left is: Pookie. It’s Pookie’s birthday. It’s Pookie who matters. It’s who Pookie is, and not what she does or what she gets, that matters.

Pookie was born four years ago at 5:30 PM on this day (except it was on a Sunday). I’m sure almost every parent feels this way, but it’s true: I cannot believe that Pookie has been with us for four years. That’s almost one seventh of my lifespan. That’s one forth of the way to her sixteenth birthday. WAH! How can this be? I feel like it was just yesterday that the nurse brought us our long bundle of baby with wild dark hair, with her wide and flat nose, her pouty lips and her giant eyes. I feel like it was just yesterday that I held her on my warm deflated and contracting belly, moments after she was born, to breastfeed her. She came out of the womb and assumed a state of contentment almost immediately. I didn’t have to do any work to breastfeed her, it came naturally to her. I stared down at her and stroked her cheek. I said all that I could say to capture what I felt. The love was repetitious and simple. “Oh, Sweetie.” “I love you.” “I love you.” “We love you so much.” “Your so precious.” “You’re so perfect.” “Hi Baby.” “You’re our baby.” “You’re such a perfect angel.” She came into the world around suppertime on a Sunday, and her cries were mild gurgles. We were wonderstruck with love, it’s true. My hormones were doing all the right things (and boy does THAT sound like a freak occurrence). It was just the three of us and a few supportive nurses. That was how it all started. Our life with Darah. Now, four years later, we have a Pookie-D and an Bouka-E. It’s not necessary but it feels good to share how lucky we feel, how much joy and love they bring into our worlds.